Predictive value of serum CA125 following optimal cytoreductive surgery during weekly cisplatin induction therapy for advanced ovarian cancer
✍ Scribed by Dr. Ronald E. Hempling; M. Steven Piver; Nachimuthu Natarajan; Trudy R. Baker; John M. Thompson; Michael L. Hicks; Curtis J. Mettlin
- Book ID
- 102926338
- Publisher
- John Wiley and Sons
- Year
- 1993
- Tongue
- English
- Weight
- 664 KB
- Volume
- 54
- Category
- Article
- ISSN
- 0022-4790
No coin nor oath required. For personal study only.
✦ Synopsis
One hundred seventy-one patients with epithelial ovarian cancer were treated on a prospective protocol of weekly cisplatin induction (1 mg/kg weekly for four courses) followed by monthly cisplatin (50 mg/m2), Adriamycin (50 mg/m2), and cyclophosphamide (750 mg/m2). Seventy-five patients with FIG0 stage I11 or IV disease who underwent optimal cytoreductive surgery (<2 cm residual disease) were treated on this protocol and had weekly as well as monthly serum CA125 levels measured. A retrospective analysis was performed in order to determine if a 250% fall in elevated serum CA125 levels during weekly cisplatin induction therapy would be predictive of findings at second look operation, normalization of serum CA125 levels (<35 u/ml) immediately prior to the third course of multiagent chemotherapy, and to determine the impact of such a decline on median progression-free interval. Positive predictive values for this parameter with respect to findings at second look operation ranged between 38% and 50% (P > 0.05). Positive predictive values for this parameter with respect to normalization of serum CA125 levels immediately prior to the third course of multiagent chemotherapy ranged between 64.2% and 89.6% ( P > 0.05). Logistic regression analysis demonstrated that a 250% fall observed in CA 125 levels during four weekly courses of chemotherapy served as an independent predictor of normalization of serum CA I25 levels (<35 u/ml) following two courses of multiagent chemotherapy ( P = 0.009) and improved median progression-free interval ( P = 0.04). Eighteen patients demonstrated a rise in serum CA125 levels during weekly induction cisplatin chemotherapy. Only one of these patients (5.5%) demonstrated a surgical complete response at the end of standard therapy.